It is now clear: The policy of the President and the House leadership is to take away healthcare insurance coverage for tens of millions of Americans.  Despite all the hype and tactics of political misdirection, according to the Congressional Budget Office, the health care plan advanced by the President and the House leadership will result in the loss of insurance coverage for over 20 million Americans.

That’s right, 20 million Americans will lose their health insurance.

For those Americans, their families and their friends, the consequences will be devastating.

Let’s look at just one category of patients, those suffering from cancer.  Prior to the passage of the Affordable Care Act—also known as “Obama Care,” approximately 10 percent of cancer patients were uninsured at the time of diagnosis.  Equally troubling, about one-third of cancer survivors reported a loss of health insurance at some point in time since their diagnosis.

For those individuals and their families, fighting cancer may mean choices that could lead to huge debts under the best of circumstances.  In addition to the physical and emotional toll of battling cancer, families without adequate healthcare coverage can face financial ruin.  According to the federal government, cancer is one of the five most costly medical conditions in the United States, forcing many patients to make decisions about their health based on their personal finances.

While some individuals diagnosed with cancer have meaningful and adequate health insurance to cover most of the costs for treatment, the uninsured and an increasing number of privately insured individuals face the prospect of crippling out-of-pocket costs.  Financial considerations that delay treatment for cancer can mean the difference between life and death.

Of course, the health care plan advanced by the House does not completely turn the clock back to the situation in the United States prior to enactment of the Affordable Care Act, but it will be pretty close.

The Cuomo Administration estimates that the bill approved by the House of Representatives and supported by the President will leave 2.7 million New Yorkers without health care coverage and cost the state $6.9 billion.

This is all the more troubling as the legislation was rammed through without public hearings and even before the well respected non-partisan Congressional Budget Office could issue its report on the impacts of the plan – both in terms of health insurance coverage and the costs.

So far, this approach of cutting out the public accountability process is being followed in the Senate as well.

What’s the rush?  Why are the President and the Congress so hell-bent on moving legislation?  Because they know that the more the public finds out, the more they will be outraged.  The House bill, for example, was opposed by the American Medical Association, the American Nurses Association, the American Hospital Association, the American Academy of Pediatrics, the American Cancer Society, the American Heart Association, the American Diabetes Association, the American Lung Association, the March of Dimes and the AARP.

And those groups are opposed for good reason — the reason identified by the Congressional Budget Office: that tens of millions of Americans will lose their health insurance.

Do the members of Congress who voted for the legislation know what they did?  Of course, they do.  Yet, when challenged as to why they voted the way they did, they will try to change the subject, or focus on some popular aspect of the plan, everything but admit that their vote will lead to the needless suffering and early deaths of many people.

It’s a disgrace.  To put ideology, or partisanship, ahead of the health of people is unconscionable.

Sure, the Affordable Care Act was imperfect, but the rest of the world’s advanced nations have figured out how to ensure that all their people don’t have to worry about paying the bills while being treated for illnesses, injuries, or diseases.

Thanks to the President and the majority in the House, tens of millions of Americans could soon have those worries.  Hopefully, the moral compass of the Congress will kick in and the final plan will offer more Americans the peace of mind that comes from having healthcare.

The number one challenge facing all of us is climate change triggered by the warming of the planet.  The rising temperatures have heated the world and have already resulted in significant changes: the melting of the ice caps, famine and drought, as well as rising sea levels, and new and unpredictable weather patterns.

Despite what policymakers in Washington – who seem to act at the beck and call of the oil, gas and coal industries – say, the climate changes that the world is experiencing are primarily the result of human activities, most notably the burning of oil, gas and coal.  That’s what the world’s experts say, and they have urged that governments act to reduce the release of greenhouse gases.

And there have been some positive results – for example, the recent agreement in Paris created a policy framework to curb the use of fossil fuels.

Yet, the burning of fossil fuels is not the only greenhouse gas; another problem is the release of methane.  While carbon dioxide (CO₂, the greenhouse gas emitted by the burning of fossil fuels) persists in the atmosphere for centuries, methane dramatically warms the planet for a decade or two before decaying to CO₂.

Global concentrations of methane are now growing faster in the atmosphere than at any other time in the past two decades.  There’s still far less total methane in the atmosphere than there is carbon dioxide — but molecule for molecule, methane traps far more heat.  Over a 100-year period, the emission of a given amount of methane is about 28 times as powerful when it comes to global warming as the emissions of an equivalent amount of carbon dioxide (even though the methane doesn’t stay around that long).

Methane is a difficult gas to track.  In part, because it can come from many different sources.  Those include natural sources like marshes and other wetlands.  But about 60 percent of methane added to the atmosphere every year comes from human activities. They include farming sources like cattle operations and rice paddies – the flooded farmland is a good place to grow the microbes that generate the gas.  Another human activity that releases methane into the atmosphere is fossil fuel exploration, which leaks methane from oil and gas wells during drilling.

Establishing plans to curb human activities that lead to the release of methane is an important component in the strategies to curb climate change.

New York State is taking some steps.  Last week, Governor Cuomo released a statewide Methane Reduction Plan.  According to the Plan, methane accounts for 9% of New York State greenhouse gas emissions. And, the full extent of methane emissions may be larger, as reporting about methane leaks is incomplete.

The Plan addresses three sectors responsible for the majority of methane emissions in NY: oil and gas, landfills, and agriculture.  The Oil and Gas section of the Plan has a number of strategies to reduce emission sources from natural gas and oil storage facilities; transmission and distribution networks; and active, closed, and abandoned natural gas wells. The Department of Environmental Conservation and Department of Public Service will act to:

• reduce methane leakage and otherwise address methane emission sources;
• enhance reporting requirements; and
• improve regulatory consistency.

According to the Plan, natural gas leaks alone make up 1% of the State’s total greenhouse gas emissions.  Those natural gas leaks, while not the largest factor in methane releases, are important.  The simplest way to reduce those leaks is by not building out the state’s fossil fuel infrastructure.  This includes infrastructure like pipelines which promote more extraction, compressor stations which vent and leak gas, and storage facilities which pose grave explosion risks.

While old and current infrastructure repairs and methane mitigation efforts are important steps — indeed, they will play a significant role in reducing methane emissions — they must be paired with a commitment to move New York beyond fossil fuels and to invest in a clean, renewable energy future.

A new controversy erupted at the state Capitol last week—a controversy over the way the Senate Republicans pay members of their governing coalition.

All legislators, both in the Senate and Assembly, receive a base pay of $79,500 and that hasn’t been raised in almost 20 years.  In addition to their base pay, lawmakers are eligible for additional pay to cover extra legislative work, usually as committee chairs or for serving in leadership positions within their respective conferences.  These stipends range from a low of $9,000 to a high of $41,500.

Lawmakers technically hold part-time positions and are allowed to seek employment outside the Legislature.  There are no significant limits on that outside income.  However, if a legislator leads a conference, or heads up a committee, the stipend is a way to offset any potential loss in outside income for the legislator spending more time doing legislative work, possibly at the expense of outside income.

That’s the theory, whether it makes sense is another matter.  There have been far too many instances of lawmakers—including those receiving significant stipend money—getting investigated for corruption as the result of using their public office for private gain.  Nevertheless, that’s the way the system works.

Under the state’s stipend system, the bonuses are written into law and allocated to a specific position.  For example, by statute a stipend is issued to the Senator who is the chair of the Senate Health Committee to compensate for the additional work of running that committee.

Yet last week there were stunning revelations that the Senate Republican majority was gaming that system and instead of issuing stipends to those positions identified in law, they were instead giving them to Senators who did not hold those positions or perform the roles set out in law.

As reported in The New York Times, instead of issuing stipends to the Senate chairs of the Codes, Energy and Health committees, the Senate instead issued them to newly-created positions, called “Vice Chairs.”  There is no mention of these positions in the law authorizing these payments.  It is unclear who made this decision, but it would be shocking if it hadn’t been decided by the Senate Majority Leader himself.  After all, the chairs of those committees surely noticed the missing stipends.

Probably not coincidentally, this group of “Vice Chairs” are all members of the Independent Democratic Conference, a group of eight Senate Democrats who have aligned with the Senate Republicans to create the majority bloc that runs that house.  Senate staffers reportedly sent false information to the state Comptroller’s office to steer the stipends to these “Vice Chairs,” inaccurately describing the recipients as committee chairs.

Later in the week, the Times reported that four Senate Republicans were also receiving stipends for legislative positions that they did not hold.

The Senate leadership has been reluctant to publicly discuss this arrangement and simply argues that their decisions are legal.  A Senate Republican lawyer’s memo provided to the press makes the legal argument that any legislator connected to the committee in some way is entitled to the extra stipend money—regardless of title or whether they did any additional work.

It’s not surprising that the Senate would not be interested in discussing this situation.  Earlier in the year when one Senate Democrat moved from the mainline Conference to the Independent Democratic Conference, questions were raised about the possibility that he would receive a stipend.  It was reported in Albany’s Times Union newspaper that he told a reporter earlier in the year that he could not get the stipend since he was not a committee chair.

But then he did get one.

It’s pretty clear that instead of using these stipends to offset the possibility of outside income loss, these stipends are used to help cement the allegiance of other Senators.  These are being used as political levers to maintain legislative power.

Sometimes Albany’s political elite forgets whose money it is that they are spending.  Taxpayer dollars should be used fairly and disclosed openly and the letter of the law followed to a tee.  Those dollars shouldn’t be used as political favors to reward legislative allies.

In this case, sending stipends to political allies is wrong and a practice that should be ended.

The high school prom and graduations are big events over the next few weeks.  In an effort to look their best, many high schoolers will go to indoor tanning stores.  That decision could harm their health.

Indoor tanning raises the risks of skin cancer as well as immune suppression, eye damage, and premature aging of the skin. The World Health Organization has elevated tanning beds to the highest cancer risk category – group 1 – “carcinogenic to humans.”

Subsequent research by the nation’s top medical facilities, including Harvard Medical School and the Yale School of Public Health, has reinforced that finding.  In New York, according to the American Cancer Society an estimated 4,900 people will be diagnosed with melanoma this year. Tens of thousands more residents will be diagnosed with basal or squamous cell carcinomas of the skin.  Many of those will be as the result of frequent use of indoor tanning.

UV radiation exposure, particularly from indoor tanning, is a leading risk factor for the development of skin cancers. While excessive exposure to the sun permanently increases one’s cancer risk through cumulative damage, indoor tanning compounds the risks by delivering concentrated bursts. This results in faster mutations in the body, as the UV rays alter the configuration of human DNA. This explains why individuals who have used tanning beds have a much greater risk of developing skin cancers as compared to those who have never used tanning devices.

The risk is significant to all users, but there has been increasing data showing the impact it can have on younger people, particularly those under the age of 18.  Currently, a substantial number of young teens are using tanning beds, with use increasing with age.  Among those teens, the rates were highest among female 17-year-old high school students.

Peer-reviewed scientific studies strengthen the indoor tanning-cancer connection.  A recent review of 27 European studies concluded:

Sunbed use is associated with a significant increase in risk of melanoma. This risk increases with number of sunbed sessions and with initial usage at a young age (<35 years). The cancerous damage associated with sunbed use is substantial and could be avoided by strict regulations.

Here in the United States, a growing number of researchers have identified the use of indoor tanning to be linked to cancers, some key findings:

• There has been a gigantic increase in the use of indoor tanning facilities – particularly among teenagers. Since 1998, teens reporting use of tanning beds has increased from 1% to 27%.  The more you expose yourself to UV radiation, the more likely you are to get skin cancer.
• When the World Health Organization determined that the UV rays found in indoor tanning booths were a human carcinogen, they also stated that individuals who used indoor tanning devices before the age of 30 increase their risk for melanoma by 75 percent.
• People who use indoor tanning equipment face a 59 percent higher risk of melanoma than those who do not, according to the American Academy of Dermatology.

The American Medical Association, American Academy of Pediatrics, American Academy of Dermatology, the Skin Cancer Foundation and World Health Organization all have called on states to bar children under 18 from tanning salons.

According to the National Conference of State Legislatures, 15 states and the District of Columbia ban the use of indoor tanning beds and booths for people under 18.  New York is not one of them.

Those over the age of 18 also need to know the facts.  Unfortunately, New York’s warning labels at indoor tanning facilities and its mandated disclosures say little about the cancer dangers associated with the use of indoor tanning.  The Cuomo Administration has the regulatory authority to strengthen those warnings and they should.

But more should be done.  Last month, the state of West Virginia joined the states that have already responded to the weight of scientific evidence and the staggering harm caused by indoor tanning by banning its use by minors.  New York should act too.

Last Fall, top associates of Governor Cuomo were indicted for alleged corruption.  In criminal complaints brought by former U.S. Attorney Preet Bharara, the Justice Department alleged that top ranking associates of the governor used their relationships to steer government contracts to the governor’s campaign donors, as well as enriching themselves personally.  $800 million of contracts were affected.  Much of the alleged illegal acts occurred in entities affiliated with the State University of New York.  Nine individuals have been indicted for extortion and bribery, and one of those has pleaded guilty.

Of course, everyone is entitled to the presumption of innocence and the allegations have to be proven in court.  However, the allegations took place at roughly the same time as the governor was successfully pushing proposals to limit the power of the state Comptroller to monitor the state’s procurement process.

Under New York’s constitution, a separately-elected Comptroller is charged with monitoring the state’s finances and managing the pension fund of public employees.  The rationale for making this a separately-elected official is to give him or her independence from the Administration.  Thus, the constitution creates political “distance” so that the Comptroller can audit the state’s books without fear or favor.

It doesn’t always work out that way.  There has long been institutional tension between a governor and the Comptroller as the state’s fiscal watchdog.

When Governor Cuomo came to office during his first term in 2011 he successfully advanced legislation that cut back the powers of the Comptroller to do his job.  At that time, the governor argued that the Comptroller’s office moved too slowly and that the governor wanted to get economic development projects moving quickly in his efforts to jump start the state’s economy.

The Comptroller offered evidence that the governor’s claims were incorrect, but the Legislature approved the governor’s proposals and in subsequent years, cut back the Comptroller’s powers even more.

Around that same time, the alleged schemes of the governor’s associates were being cooked up.  Would the Comptroller have been able to identify these corrupt actions?  We’ll never know, but the fact that an outside entity had the capacity to act might have short-circuited the efforts.

When the indictments came down, the governor promised to advance legislation to reduce the risk of corruption in the state’s system of awarding contracts.  And in his budget, the governor proposed establishing new offices to monitor the contracting process – but those individuals would be appointed by the governor.  Moreover, the governor did not propose restoring and strengthening the powers of the Comptroller, despite calls from reformers to do so.

The governor’s plan was rejected by the Legislature.

This past week, Deputy Majority Leader John DeFrancisco moved legislation to the Senate floor that strengthens the Comptroller’s powers to monitor state finances.  Identical legislation has been introduced in the Assembly.

The legislation empowers the Comptroller to approve State University of New York contracts above certain dollar thresholds before they are bid, including contracts of the SUNY Research Foundation. SUNY contracts in the areas of construction, construction-related services like engineering and architecture, materials, and printing will be newly subject to prior approval. Contracting by third party vehicles affiliated with public authorities will be banned altogether.

The bill standardizes cost-effective and fair procurement practices, requiring public authorities, public corporations, and SUNY, to establish guidelines that mirror those of state agencies such as competitive bidding, awarding contracts to the lowest priced responsible bidder, and marketing practices that create the most competitive marketplace.

Additional measures in the legislation establish greater integrity in state procurement transactions between vendors and government officials, employees and board members at state agencies and public authorities.  Both vendors and government representatives must follow a code of conduct prohibiting conflicts of interest or favoritism, requiring written recusals when conflicts do exist, reporting of any undue influence or fraud, and certifying a clean contracting process.  Failure to do so can result in hefty fines, termination of a corrupted contract, and penalties including up to a lifetime ban on vendors contracting with the state.

Taken together, these many reforms will help to restore public confidence in the contracting process following recent scandals.  It appears that the Senate is poised to act; the Assembly must follow suit and the governor should approve this important legislation.